MC archived articles

Impact on HIV transmission

Auvert B Taljaard D, Lagarde E, et al. Auvert B Taljaard D, Lagarde E, et al. PLoS Medicine, 2005; 2(11): e298Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial.This paper presents the results of the first randomized, controlled intervention trial to test the hypothesis that male circumcision may provide protection against HIV-1 infection. A total of 3,274 uncircumcised men in South Africa, aged 18–24 years, were randomized to a control or an intervention group with follow-up visits at 3, 12, and 21 months for HIV testing, physical examination and interviews. The trial was stopped early as an analysis demonstrated that male circumcision provides 60-75 per cent protection against acquiring HIV infection.

Bailey R, Moses S, Parker et al. Lancet 2007; 369 (9562): 643-56Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial.The paper presents the results the Kenyan randomized controlled trial to determine if male circumcision had a protective effect against HIV infection. The study also assesses safety and changes in sexual behaviour related to the intervention. A total of 2,784 men aged 18-24 years were randomised into intervention (circumcision) and control group (delayed circumcision), with follow up visits at 1,3,6,12,18 and 24 months. The trial was stopped after a third interim analysis showed male circumcision corresponds to a risk reduction of 53%-60%. No risk compensation after circumcision was observed. The study suggests that where appropriate, voluntary, safe and affordable circumcision services should be integrated with other HIV preventive interventions.

Kebaabetswe P, Lockman S, Mogwe S, et al. Sexually Transmitted Infections, 2003; 79:214-219Male circumcision: an acceptable strategy for HIVprevention in BotswanaThis paper is a cross sectional survey conducted in nine geographically representative locations in Botswana to determine the acceptability of male circumcision in the country, as well as the preferred age and setting for male circumcision. Interviews were conducted using standardised questionnaires. This paper shows that male circumcision appears to be highly acceptable in Botswana. The option for safe circumcision should be made available to parents in Botswana for their male children. Circumcision might also be an acceptable option for adults and adolescents, if its efficacy as an HIV prevention strategy among sexually active people is supported by clinical trials.